Unplanned transfers from Residential Aged Care Homes (RACHs) to hospitals are rising globally, with Australia experiencing an increase from 11.8% (2015) to 14% (2019). Up to 67% of these transfers, often fall-related, are deemed unnecessary. While clinical decision tools (e.g., post-fall assessment pathways) aim to enhance health professionals’ decision-making and improve healthcare delivery, research on their use in RACHs and professionals’ needs regarding post-fall management is scarce. This study aimed to identify gaps in post-fall care processes and understand related barriers and facilitators.
A mixed-methods convergent/triangulation design, with a cross-sectional survey and semi-structured interviews, was conducted with health professionals from 6 RACHs in Victoria and NSW. Descriptive statistics, Spearman's rho, and rapid qualitative inquiry were applied.
Results from 56 unit surveys and 11 interviews highlighted consistent use of fall risk assessment (95%), incident reporting (100%), and nursing record documentation post-fall (95%), but inconsistent use of structured post-fall assessment (79%). Professionals emphasised the need for training to improve their clinical expertise, enhanced observational protocols, and timely access to medical services (e.g., General Practitioner, telehealth services) to strengthen post-fall management and prevent unnecessary hospital transfers.
Clear and customised post-fall protocols that guide healthcare professionals to deliver optimal care are needed. By equipping teams with the necessary knowledge and skills, fall-related hospital transfers can be mitigated and the quality of care provided to residents, enhanced. Considering the added complexity of managing older adults with dementia after a fall, tailored training programs and protocols must reflect the specific needs of this population.